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PubMed1981

Design and evaluation of statistical control procedures: applications of a computer "quality control simulator" program.

A computer simulation program has been developed to aid in designing and evaluating statistical control procedures. This "QC stimulator" (quality control) program permits the user to study the effects of different factors on the performance of quality-control procedures. These factors may be properties of the analytical procedure, characteristics of the instrument system, or conditions for the quality-control procedure. The performance of a control procedure is characterized by its probability for rejection, as estimated at several different magnitudes of random and systematic error. These performance characteristics are presented graphically by power functions-plots of the probability for rejection vs the size of the analytical errors. The utility of this stimulation tool is illustrated by application to multi-rule single-value procedures, mean and range procedures, and a trend analysis procedure. Careful choice of control rules is necessary to minimize false rejections and to optimize error detection with multi-rule procedures. Control limits must be carefully calculated for optimum performance of mean and range procedures. The level of significance for testing control must be carefully selected for the trend analysis procedure.

Chemistry, Clinical↗
PubMed2005

SiteFind: a software tool for introducing a restriction site as a marker for successful site-directed mutagenesis.

BACKGROUND: Site-directed mutagenesis is a widely-used technique for introducing mutations into a particular DNA sequence, often with the goal of creating a point mutation in the corresponding amino acid sequence but otherwise leaving the overall sequence undisturbed. However, this method provides no means for verifying its success other than sequencing the putative mutant construct: This can quickly become an expensive method for screening for successful mutations. An alternative to sequencing is to simultaneously introduce a restriction site near the point mutation in manner such that the restriction site has no effect on the translated amino acid sequence. Thus, the novel restriction site can be used as a marker for successful mutation which can be quickly and easily assessed. However, finding a restriction site that does not disturb the corresponding amino acid sequence is a time-consuming task even for experienced researchers. A fast and easy to use computer program is needed for this task. RESULTS: We wrote a computer program, called SiteFind, to help us design a restriction site within the mutation primers without changing the peptide sequence. Because of the redundancy of genetic code, a given peptide can be encoded by many different DNA sequences. Since the list of possible restriction sites for a given DNA sequence is not always obvious, SiteFind automates this task. The number of possible sequences a computer program must search through increases exponentially as the sequence length increases. SiteFind uses a novel "moving window" algorithm to reduce the number of possible sequences to be searched to a manageable level. The user enters a nucleotide sequence, specifies what amino acid residues should be changed in the mutation, and SiteFind generates a list of possible restriction sites and what nucleotides must be changed to introduce that site. As a demonstration of its use, we successfully generated a single point mutation and a double point mutation in the wild-type sequence for Krüppel-like factor 4, an epithelium-specific transcription factor. CONCLUSION: SiteFind is an intuitive, web-based program that enables the user to introduce a novel restriction site into the mutated nucleotide sequence for use as a marker of successful mutation. It is freely available from http://www.utmb.edu/scccb/software/sitefind.html.

Algorithms↗
PubMedDate not supplied

EPIX: an interactive computer application program for cross-sectional epidemiological, periodontal investigations from X-ray films.

This article introduces the interactive computer application program EPIX and the associated personal computer/digitizer system. The system is used to measure marginal alveolar bone height and to record angular alveolar bone defects, defective margins of dental restorations and dental calculus from 5 X-magnified periapical radiographs in cross-sectional epidemiological investigations. The 134-kBytes compiled BASIC program provides 17 menu options. A complete recording of interproximal tooth surfaces takes on average 20 minutes per subject. Data from 200 subjects can be stored on one 5.25" floppy disk. EPIX transforms data files into text files to enable transfer to main-frame computer for statistical analyses. Data displays on VDU or paper are available. Routines for data location and processing, file processing and visual display of an operator's manual provide additional facilities. EPIX has been used to process an epidemiological material of 912 subjects and has proved to be useful.

Cross-Sectional Studies↗
PubMedDate not supplied

Results of a patient education project using a touch-screen computer.

PURPOSE: The purpose of this project was to increase use of the Physician Data Query and Patient Information File services of the National Cancer Institute in a clinical setting. OVERVIEW: A patient education demonstration project was conducted at the University of Rochester Cancer Center using a touch-screen computer program called CancerHelp. Two computers were purchased, one stationed in the Patient Library at the University of Rochester Cancer Center and one circulated to three affiliated hospitals. Demographic information was asked at the beginning of the program and an evaluation was elicited at the end of the program. All information was given voluntarily; users of the system could bypass the questions if they wished. The computer program was very well received by patients and their families. The program was used 1758 times over 6 months. CLINICAL IMPLICATIONS: A touch-screen computer program can be an effective method for distributing cancer information.

Adult↗
PubMed1986

Computerized quantitative analysis of kinetic visual fields.

Kinetic perimetry is still a widely accepted and used means of assessing the visual field. Attempts at quantifying the area of vision for given isopters have been limited to area measurements on visual field charts, which are azimuthal equidistant polar map projections of the inside surface of the perimetry bowl. Such measurements distort the true size of scotomas (or seeing areas) when the boundaries measured are farther from the center of the field on the chart because of cartographic distortion inherent with this projection. We believe that the solid angle in steradians subtended by the scotoma or the seeing area is a more appropriate measure of the visual field than area on a flat representation. We used a simple computer program to determine the solid computer program to determine the solid angle for given isopters of graphed perimetric visual field data.

Computers↗
PubMed2006

Drug Guru: a computer software program for drug design using medicinal chemistry rules.

Drug Guru (drug generation using rules) is a new web-based computer software program for medicinal chemists that applies a set of transformations, that is, rules, to an input structure. The transformations correspond to medicinal chemistry design rules-of-thumb taken from the historical lore of drug discovery programs. The output of the program is a list of target analogs that can be evaluated for possible future synthesis. A discussion of the features of the program is followed by an example of the software applied to sildenafil (Viagra) in generating ideas for target analogs for phosphodiesterase inhibition. Comparison with other computer-assisted drug design software is given.

Chemistry, Organic↗
PubMed1983

SYNthesis LIBrary-graphics at the bench.

As part of our continuing research program in the application of computer systems for laboratory scientists, we are developing a chemical reaction retrieval computer program. Program SYNLIB (SYNthesis LIBrary) is a joint research effort between the Chemical Technologies Department, Smith Kline & French Laboratories (SKF), and Professor W. Clark Still, Columbia University. SYNLIB employs very simple graphics instructions that permit the novice user to pose chemical structural questions against a library of chemical reaction citations. The library of citations is gleaned from the published literature and from proprietary research files. Each citation consists of the structural diagram of reactants and products, a literature reference, yield, reaction conditions, steps/reagents, and, when appropriate, disallowed coexisting functional groups. SYNLIB complements the functions of predictive synthesis computer programs (eg, SECS, LHASA), and has been enthusiastically received in our laboratories. The current program strategies will be presented and discussed, along with new research directions that derive from the distribution of chemical graphics technology into the chemical laboratory.

Chemistry, Pharmaceutical↗
PubMedDate not supplied

The differential effect of personality on computer-based treatment of agoraphobia.

The differential effects of the revised NEO Personality Inventory (NEO PI-R) personality factors and intelligence on response to a computerized vicarious exposure treatment for agoraphobia were investigated. The Fear Questionnaire (FQ), the Agoraphobia Cognitions Questionnaire (ACQ), and the Body Sensations Questionnaire (BSQ) were used to assess agoraphobic symptomatology. Fourteen females and four males with agoraphobia diagnoses completed three 45-minute weekly treatment sessions. There was a significant decrease in scores on all three measures following treatment. Compared with published population norms, the agoraphobic subjects showed very high neuroticism, low extroversion, and high openness. Lower agreeableness factor scores predicted good treatment outcome. The NEO PI-R openness factor was negatively correlated with proficiency on the computer program; however, proficiency on the computer program did not correlate with symptom improvement. Overall, these results suggest that personality interacts with treatment at different stages of the therapeutic process.

Adult↗
PubMedDate not supplied

Physician acceptance of a computerized health maintenance prompting program.

Computer prompting systems remind physicians to perform health promotion/disease prevention (HP/DP) procedures on their patients, but it is unclear how willingly physicians accept these systems. Because acceptance is critical to long-term system success, we assessed attitudes toward a computerized health maintenance program (HMP) prompting system. We surveyed 23 faculty and 52 residents in a general medicine teaching hospital group practice after the HMP had been in use for three years. Sixty-four physicians (85 percent) responded. Almost all (91 percent) agreed that all ongoing-care patients should receive periodic screening--a significant (p less than .001) increase compared to 1979, when prior to the HMP 56 percent agreed. On average, the physicians believed that 87 percent of their ongoing-care patients over 50 years of age should be enrolled in the HMP. About half (55 percent) felt that losing the HMP would limit their ability to care for their patients, and almost all (97 percent) said they would include a prompting system in any future private practice, with most (87 percent) preferring a computer-based system. A majority (65 percent) said that they liked being reminded. Prompting systems improve physician performance of HP/DP procedures. The HMP received a high level of acceptance and was associated with improved attitudes toward HP/PD activities, suggesting that computerized prompting systems should be more widespread.

Attitude of Health Personnel↗
PubMed1982

QT interval measurement by a computer assisted program: a potentially useful clinical parameter.

The duration of electrical systole (QT interval) was measured in 72 subjects (48 women and 24 men) who had normal coronary arteries and left ventricular function at cardiac catheterization (group 1). The same measurements were obtained in 100 patients with a normal ECG (from 40 women and 60 men referred to our institution and found normal on a noninvasive clinical basis) and compared to a double independent manual calculation (group 2). The computer assisted program was found reliable in QT interval measurements. In both study groups women showed longer QTc. No difference in QTc duration was seen in subjects taking beta-blockers prior to angiography. As compared to group 1, subjects of group 2 showed similar average QTc values. However, 9 out of 100 subjects of group 2 had abnormal QTc as compared with none of group 1 (p less than 0.05). QTc calculations may improve the usefulness of computer assisted programs in ECG interpretation. Present data can be used as reference values for normality. They stress in addition the necessity of introducing the heart rate correction for the interpretation of QT interval. This can help in stimulating prospective clinical studies to assess the value of QTc as an index of risk for cardiac dysrhythmias.

Adrenergic beta-Antagonists↗
PubMed1989

[The physician and the computer. 22. Programming in the Prolog language].

A modern tool of interaction with the computer is the programming language Prolog. The authors discuss its position among other languages, emphasize its different character (declarative programming). They outline basic structures of Prolog and its type of function. They also give examples of creating data bases of patients and the possibility to use this language in the creation of expert systems in medicine.

Medical Informatics↗
PubMedDate not supplied

Modeling magnetic fields in residences: validation of the resicalc program.

RESICALC is a computer program that models magnetic fields due to currents on arbitrary arrays and configurations of electric transmission lines, primary and secondary distribution lines, and ground and neutral return pathways. The program conducts network analyses of ground/neutral currents in neighborhoods based on residential loads and impedances in the current path. Experiments were conducted at the Magnetic Field Research Facility (MFRF) in Lenox, Massachusetts to validate the program's field computation. MFRF has a simulated residential electric distribution system that permits the testing of scenarios with a broad range of electrical characteristics. The results demonstrate that the program accurately models fields from complex combinations of supply and ground/neutral currents, and shows how estimated fields may be sensitive to impedance values assigned to the ground and neutral currents. The program has usefulness as an exposure assessment tool when access to residences is not possible, and as a means to estimate fields when planning electrical facility or residential development. Careful mapping of power line and residential coordinates in the program, as well as acquiring the highest quality load and grounding data available, are critical for modeling valid exposure estimates.

Computer Simulation↗
PubMed1992

Concave Ferguson plots of DNA fragments and convex Ferguson plots of bacteriophages: evaluation of molecular and fiber properties, using desktop computers.

A desktop computer program evaluating physical properties of DNA and bacteriophages is presented. The analysis is based on data obtained from capillary and submarine-type agarose electrophoresis. Native molecular/particle properties and properties of the gel (or polymer) medium can be derived from electrophoresis at several gel concentrations. This is done conveniently by a computerized evaluation of the semi-logarithmic plot of mobility vs. gel concentration, designated the Ferguson plot. In application to most proteins, this plot is linear and computer programs exist to evaluate it. However, nonlinear Ferguson plots have assumed great importance in view of the fact that the plots are concave for DNA. Similarly, convex plots are important since they prevail in the electrophoresis of large particles in agarose. The computer program reported here is the first to (i) address concave Ferguson plots and (ii) allow for the evaluation of both cases using a desktop computer. Program ELPHOFIT version 2.0, a Macintosh application, is available upon request.

Bacteriophages↗
PubMed1993

Quality assurance for respiratory care services: a computer-assisted program.

At present, the principal advantage of computer-assisted quality assurance is the acquisition of quality assurance date without resource-consuming chart reviews. A surveillance program like the medical director's alert may reduce morbidity and mortality. Previous research suggests that inadequate oxygen therapy or failures in airway management are important causes of preventable deaths in hospitals. Furthermore, preventable deaths tend to occur among patients who have lower severity-of-illness scores and who are not in ICUs. Thus, surveillance of the entire hospital, as performed by the HIS medical director's alert, may significantly impact hospital mortality related to respiratory care. Future research should critically examine the potential of such computerized systems to favorably change the morbidity and mortality of hospitalized patients. The departments of respiratory care and medical informatics at LDS Hospital have developed a computer-assisted approach to quality assurance monitoring of respiratory care services. This system provides frequent and consistent samples of a variety of respiratory care data. The immediate needs of patients are addressed through a daily surveillance system (medical director's alert). The departmental quality assurance program utilizes a separate program that monitors clinical indicators of staff performance in terms of stated departmental policies and procedures (rate-based clinical indicators). The availability of an integrated patient database allows these functions to be performed without labor-intensive chart audits.

Hospital Bed Capacity, 500 and over↗
PubMed1975

The localization of equivalent dipoles of EEG sources by the application of electrical field theory.

A technique is described for finding the position, magnitude and orientation of the equivalent electrical dipole of EEG activity given the pattern of potential differences recorded at the scalp. The technique is based on an iterative computer program implementing equations describing the electrical field of a dipole in a spherical conductor. The computer program was tested in vitro against data obtained from an inert spherical conductor (a bowl containing physiological saline, fitted with recording electrodes and a movable dipole) and an anisotropic conductor (a similarly equipped human skill including a simulated scalp). In both practical models, the computer program accurately located the dipole, the mean differences between observed and computed loci being of the order of 1 cm at widely different locations. This accuracy was maintained in the anisotropic model even though potentials transmitted through the skill were attenuated by 80%. In vivo, the program successfully located the equivalent generator of blink artefacts within the remaining eye of a one-eyed subject and, in a normal subject, localized the dipole of corresponding potentials to a midline inter-ocular position. In further investigation of normal subjects, the distribution of amplitudes at latencies within Wave V of the visual evoked response confirmed the loci of equivalent generators within posterior cerebral regions. The technique was also applied to the alpha rhythm indicating a posterior locus compatible with the view that alpha rhythm is generated chiefly by posterior cerebral cortex. Factors affecting the accuracy of the technique and the limitations of one-dipole models are discussed.

Action Potentials↗
PubMed2001

A computer-based method for calculation of orbital floor fractures from coronal computed tomography scans.

PURPOSE: A computer program recently developed for the calculation of the orbital floor and fracture areas from coronal computed tomography (CT) scans was used in a study to evaluate the accuracy and ability of this new method. MATERIAL AND METHODS: The size of orbital floors and fabricated fractures in 14 dried, anatomic specimens were measured in coronal CT scans by 3 independent observers. Based on this data set, the orbital floor and fracture regions were calculated with the newly developed computer program. These calculated regions were then compared with a direct measurement of the specimens that had been obtained by digital photography. The accuracy of the computer-based calculations was assessed using Lin's concordance correlation coefficient. RESULTS: The size of the orbital floor (mean +/- SD) was found to be 5.21 +/- 0.39 cm(2) by direct measurement of the specimens and 5.30 +/- 0.52 cm(2) by calculation with the computer program. The region of the fracture (mean +/- SD) was 1.05 +/- 0.64 cm(2) by direct measurement and 1.01 +/- 0.62 cm(2) by computer calculation. The between-method mean difference (direct measurement minus computer based calculation) was -0.09 cm(2) (or 1.7% of mean orbital floor region) for orbital floor region and 0.04 cm(2) (or 3.8% of mean fracture region) for fracture region. CONCLUSIONS: This accurate and time-saving method is practicable for determining the size and location of orbital floor fractures. This calculation program can be advantageously applied in the clinical management of blowout fractures of the orbit.

Algorithms↗
PubMed1992

Assessment of experts' approach to insulin therapy and development of a simulator for diabetes insulin adjustment.

OBJECTIVE: To develop a computer program (Macintosh) to predict changes in blood glucose after changes in insulin dose, timing, and regimen. RESEARCH DESIGN AND METHODS: We established program parameters (apparent insulin action profiles; different for insulin-dependent and non-insulin-dependent diabetes mellitus) to match predictions by five diabetes specialists at our hospital of blood glucose changes after insulin-dose adjustment in 22 hypothetical patient cases. We compared the action profiles, which represent the blood glucose changes predicted by the experts with glucose-clamp studies of insulin action. We tested the program's performance in 22 different hypothetical cases against the responses of 15 specialists from outside our hospital. RESULTS: The specialists, when predicting effects of insulin dose adjustment, integrate numerous processes (insulin action, diet, sequential blood glucose interactions). They could not specify algorithms for determining these individual factors, but they could easily predict the overall effect in the context of patient cases. The computer program's insulin-action profiles simulate this "composite" approach. The developed program incorporates multiple insulin regimens, which may be changed during the stimulation, and adjusts predicted responses according to the patient's estimated sensitivity to insulin. Its predicted change in 172 blood glucose levels (22 cases) correlated well with the corresponding means of the outside specialists (r = 0.83, P = 0.0001). Comparing this correlation with that of individual specialists ranked the program third. CONCLUSIONS: A computer program can simulate specialists' "composite" approach (not based purely on conscious application of physiological data) to insulin adjustment.

Blood Glucose↗
PubMed1995

On-line computer pharmacokinetics program: lessons learned from its failure.

Decision support computer technology (DST) embedded in laboratory or hospital information systems has great potential but has rarely been successful. Through studying a pharmacokinetic program that automatically extracted data without requiring manual data entry, we have identified several barriers to the successful implementation of DST. Manual data entry is a major barrier, but so is the entry of erroneous data such as heights, weights, drug dosing times, and specimen collection times. In such a system, unanticipated changed modes of clinical practice and software changes in the system's component modules can be incompatible with the decision-support program, necessitating software revisions. We also noted that clinicians increased their ordering of laboratory tests and changes in drug doses but without improvement in patients' outcomes. This suggests that information output from the program can be misinterpreted by clinicians. In summary, DST programs should be validated in an actual working environment.

Aminoglycosides↗